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OCD and Chemical Imbalance

drugsWhile the cause of obsessive-compulsive disorder is not actually known, many professionals and lay people often attribute the disorder to a chemical imbalance. SSRIs, which are medications that affect serotonin, are known to reduce symptoms in a good number of people with OCD. So it is reasonable to deduce that serotonin levels in those with OCD must be out of whack, right?

Well, not necessarily. That explanation is way too easy, and certainly has never been proven. Drugs often help people with all types of illnesses, but how and why they help are not always clear.  And I’m not just talking about medications for brain disorders. There are a number of cholesterol medications, blood pressure medications, anxiety-reducing  medications, rheumatoid arthritis medications – just to name a few – that work to reduce symptoms. Different drugs work for different people, and we don’t always know why. Why does acetaminophen help my husband’s headache but only ibuprofen works for me?

But really, what’s the big deal if we just use an easy explanation of “chemical imbalance” when discussing the cause of OCD, even if it’s just a theory?

Well, for one thing, if those with obsessive-compulsive disorder, or their loved ones, believe their OCD is caused by a chemical imbalance, how will they feel if medication fails to correct this supposed imbalance? Depressed? Confused? Hopeless?

And if we believe that treating OCD is as easy as raising our serotonin levels, we might just be lured into the many scams out there promising a quick fix for OCD. Raise your serotonin levels and be free of OCD ! Ah, if only it were that easy!

As imaging technology advances (PET Scans for example) and more research is conducted, we are discovering that nothing is simple when it comes to OCD. Studies have shown that those with OCD have elevated brain activity in parts of the frontal lobes (particularly the orbital cortex) and the basal ganglia. This is important information that, on the one hand, brings us closer to understanding OCD and its causes, and on the other hand, raises even more questions. Throw in the fact that genetics and environment have been shown to play a big role in the development of OCD, and it is now easier to see how we can’t just attribute the disorder to a chemical imbalance.

So where does that leave us? Well, thankfully, we do not have to fully understand the cause of obsessive-compulsive disorder to treat it effectively. Exposure and response prevention (ERP) therapy, the evidence-based Cognitive Behavioral Therapy used to treat OCD, works. It literally saved my son’s life. So while the experts are busy at work trying to decipher what actually causes OCD, those who live with the disorder can commit themselves wholeheartedly to ERP therapy. Because one thing we do know is that OCD, no matter how severe, is treatable and can be beaten.









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About Janet Singer

I am a mom whose son was completely debilitated by severe OCD in 2008. Thankfully he made a remarkable recovery and is now living life to the fullest. I've since become an advocate for OCD awareness with the goal of spreading the word that OCD, no matter how severe, is treatable. I am the author of Overcoming OCD: A Journey to Recovery (Rowman & Littlefield, January 2015) and have my own blog about OCD at There truly is hope for all those who suffer from this insidious disorder!

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APA Reference
Singer, J. (2016). OCD and Chemical Imbalance. Psych Central. Retrieved on March 17, 2018, from